1
|
Pereira M, Tocino MLS, Mas-Fontao S, Manso P, Burgos M, Carneiro D, Ortiz A, Arenas MD, González-Parra E. Dependency and frailty in the older haemodialysis patient. BMC Geriatr 2024; 24:416. [PMID: 38730386 PMCID: PMC11088105 DOI: 10.1186/s12877-024-04973-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 04/12/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Frailty among older adults undergoing hemodialysis is increasingly prevalent, significantly impacting cognitive function, mobility, and social engagement. This study focuses on the clinical profiles of very older adults in hemodialysis, particularly examining the interplay of dependency and frailty, and their influence on dialysis regimens. METHODS In this observational, descriptive study, 107 patients aged over 75 from four outpatient centers and one hospital unit were examined over a year. Patient data encompassed sociodemographic factors, dialysis specifics, analytical outcomes, lifestyle elements, and self-reported post-treatment fatigue. Malnutrition-inflammation scale was used to measure the Nutritional status; MIS scale for malnutrition-inflammation, Barthel index for dependency, Charlson comorbidity index; FRIED scale for frailty and the SF12 quality of life measure. RESULTS The study unveiled that a substantial number of older adults on hemodialysis faced malnutrition (55%), dependency (21%), frailty (46%), and diminished quality of life (57%). Patients with dependency were distinctively marked by higher comorbidity, severe malnutrition, enhanced frailty, nursing home residency, dependency on ambulance transportation, and significantly limited mobility, with 77% unable to walk. Notably, 56% of participants experienced considerable post-dialysis fatigue, correlating with higher comorbidity, increased dependency, and poorer quality of life. Despite varying clinical conditions, dialysis patterns were consistent across the patient cohort. CONCLUSIONS The older adult cohort, averaging over four years on hemodialysis, exhibited high rates of comorbidity, frailty, and dependency, necessitating substantial support in transport and living arrangements. A third of these patients lacked residual urine output, yet their dialysis regimen mirrored those with preserved output. The study underscores the imperative for tailored therapeutic strategies to mitigate dependency, preserve residual renal function, and alleviate post-dialysis fatigue, ultimately enhancing the physical quality of life for these patients.
Collapse
Affiliation(s)
- M Pereira
- Fundación Renal Íñigo Álvarez de Toledo, Madrid, 28003, Spain
| | - M L Sanchez Tocino
- Fundación Renal Íñigo Álvarez de Toledo, Madrid, 28003, Spain
- Facultad de Enfermería, Universidad de Salamanca, Salamanca, Spain
| | - Sebastian Mas-Fontao
- Instituto de Investigación Sanitaria Fundación Jimenez Díaz, Madrid, 28040, Spain.
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain.
- Facultad de Medicina y Biomedicina, Universidad Alfonso X, Villanueva de la Cañada, Spain.
| | - P Manso
- Fundación Renal Íñigo Álvarez de Toledo, Madrid, 28003, Spain
| | - M Burgos
- Fundación Renal Íñigo Álvarez de Toledo, Madrid, 28003, Spain
| | - D Carneiro
- Fundación Renal Íñigo Álvarez de Toledo, Madrid, 28003, Spain
| | - A Ortiz
- Instituto de Investigación Sanitaria Fundación Jimenez Díaz, Madrid, 28040, Spain
- Servicio de Nefrología, Fundación Jiménez Díaz, Madrid, Spain
| | - M D Arenas
- Fundación Renal Íñigo Álvarez de Toledo, Madrid, 28003, Spain
| | - E González-Parra
- Fundación Renal Íñigo Álvarez de Toledo, Madrid, 28003, Spain.
- Instituto de Investigación Sanitaria Fundación Jimenez Díaz, Madrid, 28040, Spain.
- Servicio de Nefrología, Fundación Jiménez Díaz, Madrid, Spain.
| |
Collapse
|
2
|
Thomas JA, Ditchman NM, Guidotti Breting L, Narayanan J. Quality of life in people with epilepsy: The associations of anti-seizure medications and biopsychosocial variables. Epilepsy Behav 2024; 152:109664. [PMID: 38320411 DOI: 10.1016/j.yebeh.2024.109664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 01/22/2024] [Accepted: 01/23/2024] [Indexed: 02/08/2024]
Abstract
People with epilepsy, on average, experience lower quality of life (QOL) than healthy controls. This study examined the associations between specific anti-seizure medications, biopsychosocial factors, and QOL in people with epilepsy. Analysis of covariance revealed that individuals taking three or more anti-seizure medications had significantly lower QOL than those taking levetiracetam. Findings also demonstrated that when examining biopsychosocial factors as predictors of QOL in hierarchical regression, anxiety, depression, and daytime sleepiness were significant predictors of QOL. Once these factors were entered into the model, number of medications was no longer significant. The final model predicted 59.6% of the variance in QOL. In clinical settings, providers should take a patient-centered approach that includes regular assessment of QOL and an emphasis on good psychological care for those coping with anxiety, depression, and sleep difficulty. These findings underscore the importance of addressing psychological health and sleep factors within the epilepsy population.
Collapse
Affiliation(s)
- Julia A Thomas
- Illinois Institute of Technology, 3424 S. State St, Chicago, IL 60616, United States; Barrow Neurological Institute, 222 W. Thomas Road, Ste. 315, Phoenix, AZ 85013, United States.
| | - Nicole M Ditchman
- Illinois Institute of Technology, 3424 S. State St, Chicago, IL 60616, United States.
| | - Leslie Guidotti Breting
- NorthShore University Health System, 909 Davis St, Ste. 160, Evanston, IL 60201, United States.
| | - Jaishree Narayanan
- NorthShore University Health System, 909 Davis St, Ste. 160, Evanston, IL 60201, United States; Tulane University School of Medicine, New Orleans, LA, United States.
| |
Collapse
|
3
|
Hanlon P, Wightman H, Politis M, Kirkpatrick S, Jones C, Andrew MK, Vetrano DL, Dent E, Hoogendijk EO. The relationship between frailty and social vulnerability: a systematic review. THE LANCET. HEALTHY LONGEVITY 2024; 5:e214-e226. [PMID: 38432249 DOI: 10.1016/s2666-7568(23)00263-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 11/28/2023] [Accepted: 11/28/2023] [Indexed: 03/05/2024] Open
Abstract
Both frailty (reduced physiological reserve) and social vulnerability (scarcity of adequate social connections, support, or interaction) become more common as people age and are associated with adverse consequences. Analyses of the relationships between these constructs can be limited by the wide range of measures used to assess them. In this systematic review, we synthesised 130 observational studies assessing the association between frailty and social vulnerability, the bidirectional longitudinal relationships between constructs, and their joint associations with adverse health outcomes. Frailty, across assessment type, was associated with increased loneliness and social isolation, perceived inadequacy of social support, and reduced social participation. Each of these social vulnerability components was also associated with more rapid progression of frailty and lower odds of improvement compared with the absence of that social vulnerability component (eg, more rapid frailty progression in people with social isolation vs those who were not socially isolated). Combinations of frailty and social vulnerability were associated with increased mortality, decline in physical function, and cognitive impairment. Clinical and public health measures targeting frailty or social vulnerability should, therefore, account for both frailty and social vulnerability.
Collapse
Affiliation(s)
- Peter Hanlon
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK.
| | - Heather Wightman
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Marina Politis
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | | | - Caitlin Jones
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Melissa K Andrew
- Division of Geriatric Medicine, Department of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Davide L Vetrano
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Stockholm Gerontological Research Center, Stockholm, Sweden
| | - Elsa Dent
- Centre for Public Health, Equity and Human Flourishing, Torrens University, Adelaide, SA, Australia
| | - Emiel O Hoogendijk
- Department of Epidemiology & Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC-Location VU University Medical Center, Amsterdam, Netherlands
| |
Collapse
|
4
|
Lee T, Chung J, Song K, Ji Y. Prevalence and associated factors of cognitive frailty in community-dwelling older adults: Results from the Korean longitudinal study of aging. Int J Older People Nurs 2023; 18:e12576. [PMID: 37776018 DOI: 10.1111/opn.12576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 07/13/2023] [Accepted: 09/17/2023] [Indexed: 10/01/2023]
Abstract
BACKGROUND Cognitive frailty, a condition characterized by physical frailty with cognitive impairment, is emerging as a determinant of adverse health outcomes in older adults. However, its prevalence and correlation with associated factors are unknown in the aging population of Korea. OBJECTIVES To estimate the prevalence of cognitive frailty and identify factors associated with it among older Korean adults. METHODS A secondary analysis was performed using the Korean Longitudinal Study of Aging seventh survey dataset collected in 2018. Multinomial logistic regression analyses were conducted to examine the association between cognitive frailty and demographic, psychosocial, oral health and physical function factors. Individuals aged ≥65 years and without dementia were included (N = 1024). Participants were classified into four groups based on the presence or absence of physical frailty and mild cognitive impairment. This article is executed in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement. RESULTS The prevalence of cognitive frailty in the study sample was 11.2%. The results of multinomial logistic regression showed that advanced age, being female, lower education levels, heart disease, arthritis or rheumatoid arthritis, underweight, depression, non-social activity, poor oral health and functional limitation were significantly associated with cognitive frailty. CONCLUSIONS Cognitive frailty is prevalent among community-dwelling older adults in Korea. The findings provide primary care providers with insights about effective strategies for identifying at-risk individuals and will guide the development of population-level interventions to prevent or delay the onset of physical frailty and cognitive impairment in older adults. IMPLICATIONS FOR PRACTICE The findings provide practical information to healthcare providers for identifying cognitive frailty in older adults. The risk factors of cognitive frailty, such as psychosocial, oral health, and physical function factors, should be thoroughly monitored for older adults. Health personnel working in primary care have a critical role in identifying risk and beneficial factors and promoting preventative strategies that enhance health outcomes.
Collapse
Affiliation(s)
- Taewha Lee
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, South Korea
| | - Jane Chung
- Virginia Commonwealth University School of Nursing, Richmond, Virginia, USA
| | - Kijun Song
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, South Korea
| | - Yoonjung Ji
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, South Korea
- Brain Korea 21 FOUR Project, College of Nursing, Yonsei University, Seoul, South Korea
| |
Collapse
|
5
|
Sharifi S, Babaei Khorzoughi K, Khaledi-Paveh B, Rahmati M. Association of intergenerational relationship and supports with cognitive performance in older adults: A systematic review. Geriatr Nurs 2023; 52:146-151. [PMID: 37307634 DOI: 10.1016/j.gerinurse.2023.05.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 05/22/2023] [Accepted: 05/24/2023] [Indexed: 06/14/2023]
Abstract
OBJECTIVE As individuals age, cognitive decline can significantly impact their quality of life. This systematic review aims to investigate the potential association between parent-child relationships among older adults in Eastern Asian countries and their cognitive performance. METHODS For this research, a systematic search was conducted on several electronic databases including PubMed, Scopus, Web of Science, ScienceDirect, and Google Scholar search engine, up to March 2023. RESULTS Out of 418 articles, 6 were eligible for inclusion in the study. The findings suggest that intergenerational relationships, particularly emotional support and two-way financial communications, are associated with maintaining cognitive health in older adults. CONCLUSIONS Intergenerational relationships affect cognitive health in older adults, with implications for healthcare, social welfare, and the economy. Further research is required to investigate the effects of children's visits on cognitive health and explore the complexities of intergenerational relationships on cognitive health in aging populations.
Collapse
Affiliation(s)
- Sina Sharifi
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Kimia Babaei Khorzoughi
- Faculty of Education and Psychology, Islamic Azad University Isfahan (Khorasgan) Branch, Isfahan, Iran
| | - Behnam Khaledi-Paveh
- Department of Geriatric and Psychiatric Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran
| | - Mahmoud Rahmati
- Department of Geriatric and Psychiatric Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran.
| |
Collapse
|
6
|
Jenkins ND, Welstead M, Stirland L, Hoogendijk EO, Armstrong JJ, Robitaille A, Muniz-Terrera G. Frailty trajectories and associated factors in the years prior to death: evidence from 14 countries in the Survey of Health, Aging and Retirement in Europe. BMC Geriatr 2023; 23:49. [PMID: 36703138 PMCID: PMC9881297 DOI: 10.1186/s12877-023-03736-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 01/09/2023] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Age-related changes in frailty have been documented in the literature. However, the evidence regarding changes in frailty prior to death is scarce. Understanding patterns of frailty progression as individuals approach death could inform care and potentially lead to interventions to improve individual's well-being at the end of life. In this paper, we estimate the progression of frailty in the years prior to death. METHODS Using data from 8,317 deceased participants of the Survey of Health, Ageing, and Retirement in Europe, we derived a 56-item Frailty Index. In a coordinated analysis of repeated measures of the frailty index in 14 countries, we fitted growth curve models to estimate trajectories of frailty as a function of distance to death controlling both the level and rate of frailty progression for age, sex, years to death and dementia diagnosis. RESULTS Across all countries, frailty before death progressed linearly. In 12 of the 14 countries included in our analyses, women had higher levels of frailty close to the time of death, although they progressed at a slower rate than men (e.g. Switzerland (-0.008, SE = 0.003) and Spain (-0.004, SE = 0.002)). Older age at the time of death and incident dementia were associated with higher levels and increased rate of change in frailty, whilst higher education was associated with lower levels of frailty in the year preceding death (e.g. Denmark (0.000, SE = 0.001)). CONCLUSION The progression of frailty before death was linear. Our results suggest that interventions aimed at slowing frailty progression may need to be different for men and women. Further longitudinal research on individual patterns and changes of frailty is warranted to support the development of personalized care pathways at the end of life.
Collapse
Affiliation(s)
- Natalie D Jenkins
- Edinburgh Dementia Prevention, University of Edinburgh, Edinburgh, Scotland.,Glasgow Brain Injury Research Group, University of Glasgow, Glasgow, Scotland
| | - Miles Welstead
- Edinburgh Dementia Prevention, University of Edinburgh, Edinburgh, Scotland.
| | - Lucy Stirland
- Edinburgh Dementia Prevention, University of Edinburgh, Edinburgh, Scotland
| | - Emiel O Hoogendijk
- Department of Epidemiology & Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC - Location VU University Medical Center, Amsterdam, the Netherlands
| | - Joshua J Armstrong
- Department of Health Sciences, Lakehead University, Thunder Bay, ON, Canada
| | - Annie Robitaille
- Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Graciela Muniz-Terrera
- Edinburgh Dementia Prevention, University of Edinburgh, Edinburgh, Scotland.,Department of Neurology, Oregon Health & Science University, Portland, OR, USA.,Department Social Medicine, Ohio University, Athens, USA
| |
Collapse
|
7
|
Zhang Z, Zhang S, Huang J, Cao X, Hou C, Luo Z, Wang X, Liu X, Li Q, Zhang X, Guo Y, Xiao H, Xie T, Zhou X. Association between abnormal plasma metabolism and brain atrophy in alcohol-dependent patients. Front Mol Neurosci 2022; 15:999938. [PMID: 36583081 PMCID: PMC9792671 DOI: 10.3389/fnmol.2022.999938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 11/16/2022] [Indexed: 12/15/2022] Open
Abstract
Objective In this study, we aimed to characterize the plasma metabolic profiles of brain atrophy and alcohol dependence (s) and to identify the underlying pathogenesis of brain atrophy related to alcohol dependence. Methods We acquired the plasma samples of alcohol-dependent patients and performed non-targeted metabolomic profiling analysis to identify alterations of key metabolites in the plasma of BA-ADPs. Machine learning algorithms and bioinformatic analysis were also used to identify predictive biomarkers and investigate their possible roles in brain atrophy related to alcohol dependence. Results A total of 26 plasma metabolites were significantly altered in the BA-ADPs group when compared with a group featuring alcohol-dependent patients without brain atrophy (NBA-ADPs). Nine of these differential metabolites were further identified as potential biomarkers for BA-ADPs. Receiver operating characteristic curves demonstrated that these potential biomarkers exhibited good sensitivity and specificity for distinguishing BA-ADPs from NBA-ADPs. Moreover, metabolic pathway analysis suggested that glycerophospholipid metabolism may be highly involved in the pathogenesis of alcohol-induced brain atrophy. Conclusion This plasma metabolomic study provides a valuable resource for enhancing our understanding of alcohol-induced brain atrophy and offers potential targets for therapeutic intervention.
Collapse
Affiliation(s)
- Zheyu Zhang
- Department of Addiction Medicine, Hunan Institute of Mental Health, Brain Hospital of Hunan Province (The Second People’s Hospital of Hunan Province), Changsha, China,Department of Integrated Traditional Chinese & Western Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Sifang Zhang
- Department of Addiction Medicine, Hunan Institute of Mental Health, Brain Hospital of Hunan Province (The Second People’s Hospital of Hunan Province), Changsha, China,Department of Integrated Traditional Chinese & Western Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Jianhua Huang
- Hunan Academy of Chinese Medicine, Hunan University of Chinese Medicine, Changsha, China
| | - Xiaoyun Cao
- Department of Addiction Medicine, Hunan Institute of Mental Health, Brain Hospital of Hunan Province (The Second People’s Hospital of Hunan Province), Changsha, China,The School of Clinical Medicine, Hunan University of Chinese Medicine, Changsha, China
| | - Chao Hou
- Department of Addiction Medicine, Hunan Institute of Mental Health, Brain Hospital of Hunan Province (The Second People’s Hospital of Hunan Province), Changsha, China,The School of Clinical Medicine, Hunan University of Chinese Medicine, Changsha, China
| | - Zhihong Luo
- Department of Addiction Medicine, Hunan Institute of Mental Health, Brain Hospital of Hunan Province (The Second People’s Hospital of Hunan Province), Changsha, China,The School of Clinical Medicine, Hunan University of Chinese Medicine, Changsha, China
| | - Xiaoyan Wang
- Department of Addiction Medicine, Hunan Institute of Mental Health, Brain Hospital of Hunan Province (The Second People’s Hospital of Hunan Province), Changsha, China,The School of Clinical Medicine, Hunan University of Chinese Medicine, Changsha, China
| | - Xuejun Liu
- Department of Addiction Medicine, Hunan Institute of Mental Health, Brain Hospital of Hunan Province (The Second People’s Hospital of Hunan Province), Changsha, China,The School of Clinical Medicine, Hunan University of Chinese Medicine, Changsha, China
| | - Qiang Li
- Department of Addiction Medicine, Hunan Institute of Mental Health, Brain Hospital of Hunan Province (The Second People’s Hospital of Hunan Province), Changsha, China,The School of Clinical Medicine, Hunan University of Chinese Medicine, Changsha, China
| | - Xi Zhang
- Department of Addiction Medicine, Hunan Institute of Mental Health, Brain Hospital of Hunan Province (The Second People’s Hospital of Hunan Province), Changsha, China,The School of Clinical Medicine, Hunan University of Chinese Medicine, Changsha, China
| | - Yujun Guo
- Department of Addiction Medicine, Hunan Institute of Mental Health, Brain Hospital of Hunan Province (The Second People’s Hospital of Hunan Province), Changsha, China,The School of Clinical Medicine, Hunan University of Chinese Medicine, Changsha, China
| | - Huiqiong Xiao
- Department of Addiction Medicine, Hunan Institute of Mental Health, Brain Hospital of Hunan Province (The Second People’s Hospital of Hunan Province), Changsha, China,The School of Clinical Medicine, Hunan University of Chinese Medicine, Changsha, China
| | - Ting Xie
- Department of Addiction Medicine, Hunan Institute of Mental Health, Brain Hospital of Hunan Province (The Second People’s Hospital of Hunan Province), Changsha, China,The School of Clinical Medicine, Hunan University of Chinese Medicine, Changsha, China
| | - Xuhui Zhou
- Department of Addiction Medicine, Hunan Institute of Mental Health, Brain Hospital of Hunan Province (The Second People’s Hospital of Hunan Province), Changsha, China,The School of Clinical Medicine, Hunan University of Chinese Medicine, Changsha, China,*Correspondence: Xuhui Zhou,
| |
Collapse
|
8
|
Jia Z, Gao Y, Zhao L, Han S. Longitudinal Relationship between Cognitive Function and Health-Related Quality of Life among Middle-Aged and Older Patients with Diabetes in China: Digital Usage Behavior Differences. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191912400. [PMID: 36231699 PMCID: PMC9566018 DOI: 10.3390/ijerph191912400] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 09/24/2022] [Accepted: 09/26/2022] [Indexed: 06/07/2023]
Abstract
BACKGROUND Cognitive function and health-related quality of life (HRQoL) are important issues in diabetes care. According to the China Association for Aging, it is estimated that by 2030, the number of elderly people with dementia in China will reach 22 million. The World Health Organization reports that by 2044, the number of people with diabetes in China is expected to reach 175 million. METHODS Cohort analyses were conducted based on 854 diabetic patients aged ≥45 years from the third (2015) and fourth (2018) survey of the China Health and Retirement Longitudinal Study (CHARLS). Correlation analysis, repeated-measures variance analysis, and cross-lagged panel models were used to measure the difference in digital usage behavior in the established relationship. RESULTS The results show that the cognitive function of middle-aged and older diabetic patients is positively correlated with HRQoL. HRQoL at T1 could significantly predict cognitive function at T2 (PCS: B = 0.12, p < 0.01; MCS: B = 0.14, p < 0.01). This relationship is more associated with individual performance than digital usage behavior. CONCLUSIONS Unidirectional associations may exist between cognitive function and HRQoL among middle-aged and older Chinese diabetes patients. In the future, doctors and nurses can recognize the lowering of self-perceived HRQoL of middle-aged and older diabetic patients, and thus draw more attention to their cognitive function, in turn strengthening the evaluation, detection, and intervention of their cognitive function.
Collapse
|
9
|
Maruta M, Shimokihara S, Makizako H, Ikeda Y, Han G, Akasaki Y, Hidaka Y, Kamasaki T, Kubozono T, Ohishi M, Tabira T. Associations between apathy and comprehensive frailty as assessed by the Kihon Checklist among community-dwelling Japanese older adults. Psychogeriatrics 2022; 22:651-658. [PMID: 35753049 DOI: 10.1111/psyg.12867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 05/20/2022] [Accepted: 05/28/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Frailty is a multidimensional condition characterised by reduced physical and psychological resilience. Older adults also frequently demonstrate apathy, suggesting that it shares similar neuro-physiological pathways with frailty. This cross-sectional study aimed to investigate the association between apathy and frailty as defined by a comprehensive assessment. METHODS We analyzed 882 older adults (mean age: 74.4 ± 6.4 years; 62.1% female) who participated in a community-based health check survey (Tarumizu Study). Apathy was measured by the Geriatric Depression Scale-3A, a three-item subset of the Geriatric Depression Scale-15, and frailty by the Kihon Checklist of physical, psychological, functional, and social status. Associations were examined by multinomial logistic regression with frailty status (robust, pre-frailty, frailty) as the dependent variable, apathy as the independent variable, and sociodemographic factors, medications, cognitive function, functional capacity, and mood symptoms as potential confounders. RESULTS Apathy was observed in 23.7% of individuals, and logistic regression revealed significant associations with both pre-frailty and frailty after confounder adjustment (pre-frailty: odds ratio (OR) 1.80, 95% CI 1.22-2.64; frailty: OR 3.24, 95% CI 1.63-6.42). Participants with apathy also exhibited greater deficits in the Kihon Checklist subdomains instrumental activities of daily living (P = 0.022), physical function (P < 0.001), oral function (P < 0.001), and cognitive function (P = 0.001). CONCLUSIONS Our findings underscore the importance of comprehensive frailty assessment and demonstrate that apathy can have pervasive deleterious effects on geriatric health.
Collapse
Affiliation(s)
- Michio Maruta
- Department of Rehabilitation, Medical Corporation, Sanshukai, Okatsu Hospital, Kagoshima, Japan.,Visiting Researcher, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Suguru Shimokihara
- Graduate School of Health Sciences, Kagoshima University, Kagoshima, Japan
| | - Hyuma Makizako
- Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Yuriko Ikeda
- Department of Occupational Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Gwanghee Han
- Visiting Researcher, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Yoshihiko Akasaki
- Graduate School of Health Sciences, Kagoshima University, Kagoshima, Japan
| | - Yuma Hidaka
- Department of Rehabilitation, Medical Corporation, Sanshukai, Okatsu Hospital, Kagoshima, Japan.,Graduate School of Health Sciences, Kagoshima University, Kagoshima, Japan
| | - Taishiro Kamasaki
- Graduate School of Health Sciences, Kagoshima University, Kagoshima, Japan
| | - Takuro Kubozono
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Mitsuru Ohishi
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Takayuki Tabira
- Department of Occupational Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| |
Collapse
|
10
|
Litwin H, Levinsky M. The Interplay of Personality Traits and Social Network Characteristics in the Subjective Well-Being of Older Adults. Res Aging 2022:1640275221113048. [PMID: 35938222 DOI: 10.1177/01640275221113048] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Using data from the Survey of Health, Ageing and Retirement in Europe, we regressed three well-being measures (CASP, life satisfaction and Euro-D depressive symptoms) on indicators of personality and social network. Personality was indicated by the Big-Five personality traits, while social network was measured in terms of size, contact frequency and emotional closeness. The analysis also considered personality-network interactions, controlling for confounders. The sample was comprised of 35,145 adults, aged 50 and older, from 24 European countries and Israel. The results revealed that the personality traits explained more variance in the well-being outcomes than the social network characteristics did. However, the interactions showed that the social network characteristics, particularly size and mean emotional closeness, offset the effects of dysfunctional personality attributes on subjective well-being in late life. Hence, social network characteristics were shown to modify the potentially ill effects of personality on key well-being indicators.
Collapse
Affiliation(s)
- Howard Litwin
- Israel Gerontological Data Center, Paul Baerwald School of Social Work and Social Welfare, 4321The Hebrew University of Jerusalem, Mount Scopus, Jerusalem, Israel
| | - Michal Levinsky
- Israel Gerontological Data Center, Paul Baerwald School of Social Work and Social Welfare, 4321The Hebrew University of Jerusalem, Mount Scopus, Jerusalem, Israel
| |
Collapse
|
11
|
Aylward A, Gordon SA, Murphy-Meyers M, Allen CM, Patel NS, Gurgel RK. Caregiver Quality of Life After Cochlear Implantation in Older Adults. Otol Neurotol 2022; 43:e191-e197. [PMID: 34855684 PMCID: PMC8752477 DOI: 10.1097/mao.0000000000003427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To evaluate factors affecting quality of life (QOL) in caregivers of older cochlear implant (CI) recipients. STUDY DESIGN Cross-sectional survey. SETTING Academic medical center. PATIENTS Adults over age 65 receiving CI between July 13, 2000 and April 3, 2019. INTERVENTIONS Cochlear implantation. MAIN OUTCOME MEASURES Linear regression models for caregiver QOL measured by Significant Other Scale for Hearing Disability (SOS-HEAR), with independent variables: caregiver role, patient gender, 11 factor modified frailty index (mFI), duration of hearing loss, hearing aid use, age at surgery, time since surgery, change in pure tone average (PTA), processor input type and Nijmegen Cochlear Implant Questionnaire (NCIQ). Correlations between SOS-HEAR and patient speech recognition scores. RESULTS Questionnaires were mailed to all 294 living CI recipients. Seventy-one caregivers completed the questionnaire. Only patient gender and mFi were significant predictors of caregiver QOL on both univariate (p ≤ 0.001, β= -20.26 [95% confidence interval -30.21, -10.3]; 0.005, -0.72 [-1.20, -0.23], respectively) and multivariate (p = 0.005, β = -20.09, -33.05 to -7.13; 0.003, -0.93 [-1.50, -0.37]) analysis, where caregivers of female patients with lower mFI (better health) had better QOL scores. Caregiver QOL was significantly associated with patient's change in PTA and self-reported QOL scores on univariate (p = 0.041, β = 0.52 [0.08, 0.96]; 0.024, -0.27 [-0.52, -0.02]) but not multivariate analysis. Time since CI was significant only on multivariate analysis (0.041, -0.17 [-0.33, -0.01]). Caregiver QOL did not correlate with patient speech recognition scores. CONCLUSIONS Higher QOL scores were found among caregivers of healthier, female CI recipients. Patient hearing measurements did not correspond with better caregiver QOL.
Collapse
Affiliation(s)
- Alana Aylward
- Division of Otolaryngology - Head and Neck Surgery, University of Utah, Salt Lake City, Utah
| | - Steven A Gordon
- Division of Otolaryngology - Head and Neck Surgery, University of Utah, Salt Lake City, Utah
| | | | | | - Neil S Patel
- Division of Otolaryngology - Head and Neck Surgery, University of Utah, Salt Lake City, Utah
| | - Richard K Gurgel
- Division of Otolaryngology - Head and Neck Surgery, University of Utah, Salt Lake City, Utah
| |
Collapse
|
12
|
|
13
|
Rockwood K, Andrew MK, Aubertin‐Leheudre M, Belleville S, Bherer L, Bowles SK, Kehler DS, Lim A, Middleton L, Phillips N, Wallace LM. CCCDTD5: Reducing the risk of later-life dementia. Evidence informing the Fifth Canadian Consensus Conference on the Diagnosis and Treatment of Dementia (CCCDTD-5). ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2020; 6:e12083. [PMID: 33204818 PMCID: PMC7656906 DOI: 10.1002/trc2.12083] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 08/14/2020] [Indexed: 11/23/2022]
Abstract
The Fifth Canadian Consensus Conference on the Diagnosis and Treatment of Dementia (CCCDTD-5) was a year-long process to synthesize the best available evidence on several topics. Our group undertook evaluation of risk reduction, in eight domains: nutrition; physical activity; hearing; sleep; cognitive training and stimulation; social engagement and education; frailty; and medications. Here we describe the rationale for the undertaking and summarize the background evidence-this is also tabulated in the Appendix. We further comment specifically on the relationship between age and dementia, and offer some suggestions for how reducing the risk of dementia in the seventh decade and beyond might be considered if we are to improve prospects for prevention in the near term. We draw to attention that a well-specified model of success in dementia prevention need not equate to the elimination of cognitive impairment in late life.
Collapse
Affiliation(s)
- Kenneth Rockwood
- Division of Geriatric MedicineDalhousie UniversityHalifaxNova ScotiaCanada
| | - Melissa K. Andrew
- Division of Geriatric MedicineDalhousie UniversityHalifaxNova ScotiaCanada
| | | | - Sylvie Belleville
- Research CenterInstitut Universitaire de Gériatrie de MontréalMontréalQuebecCanada
- Psychology DepartmentUniversité de MontréalMontréalCanada
| | - Louis Bherer
- Département de Médecine, Faculté de médecine, Université de Montréal, Centre de recherche, Institut de cardiologie de Montréal, Centre de rechercheInstitut universitaire de gériatrie de MontréalMontréalQuébecCanada
| | - Susan K. Bowles
- Division of Geriatric MedicineDalhousie UniversityHalifaxNova ScotiaCanada
- College of PharmacyDalhousie UniversityHalifaxNova ScotiaCanada
| | - D Scott Kehler
- School of PhysiotherapyDalhousie UniversityHalifaxNova ScotiaCanada
| | - Andrew Lim
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences CentreUniversity of TorontoTorontoOntarioCanada
| | - Laura Middleton
- Department of KinesiologyUniversity of WaterlooWaterlooOntarioCanada
| | - Natalie Phillips
- Department of PsychologyConcordia UniversityMontréalQuébecCanada
| | | |
Collapse
|
14
|
Yagi A, Nouchi R, Murayama K, Sakaki M, Kawashima R. The Role of Cognitive Control in Age-Related Changes in Well-Being. Front Aging Neurosci 2020; 12:198. [PMID: 32848699 PMCID: PMC7396630 DOI: 10.3389/fnagi.2020.00198] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 06/08/2020] [Indexed: 12/21/2022] Open
Abstract
Maintaining emotional well-being in late life is crucial for achieving successful and healthy aging. While previous research from Western cultures has documented that emotional well-being improves as individuals get older, previous research provided mixed evidence on the effects of age on well-being in Eastern Asian cultures. However, previous studies in East Asia do not always take into account the effects of cognitive control—an ability which has been considered as a key to enable older adults to regulate their emotions. In the current study, we tested whether cognitive control abilities interact with age in determining individuals’ well-being in 59 Japanese females (age range: 26–79; Mage = 64.95). Participants’ mental health and mental fatigue were tracked for 5 years together with their cognitive control abilities. We found that as individuals became older, they showed improved mental health and decreased mental fatigue. In addition, we found a quadratic effect of age on mental fatigue, which was further qualified by baseline cognitive control abilities. Specifically, in those who had a lower level of cognitive control abilities, mental fatigue declined until the mid-60s, at which point it started increasing (a U-shape effect). In contrast, in those who had a higher level of cognitive control ability, mental fatigue showed a steady decrease with age even after their mid-60s. These results suggest that whether advancing age is associated with positive vs. negative changes in well-being depends on cognitive control abilities, and that preserved cognitive control is a key to maintain well-being in late life.
Collapse
Affiliation(s)
- Ayano Yagi
- Research Institute, Kochi University of Technology, Kami, Japan
| | - Rui Nouchi
- Institute of Development, Aging, and Cancer (IDAC), Tohoku University, Sendai, Japan
| | - Kou Murayama
- Research Institute, Kochi University of Technology, Kami, Japan.,School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - Michiko Sakaki
- Research Institute, Kochi University of Technology, Kami, Japan.,School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - Ryuta Kawashima
- Institute of Development, Aging, and Cancer (IDAC), Tohoku University, Sendai, Japan
| |
Collapse
|
15
|
[Impact of frailty status on health and quality of life in Spanish older adults]. Aten Primaria 2019; 52:731-737. [PMID: 31883784 PMCID: PMC8054304 DOI: 10.1016/j.aprim.2019.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 10/17/2019] [Accepted: 11/27/2019] [Indexed: 12/04/2022] Open
Abstract
Objetivo El objetivo de este trabajo se centra en evaluar la capacidad predictiva de una medida latente de fragilidad basada en los indicadores físicos propuestos para la Encuesta de Salud, Envejecimiento y Jubilación en Europa (SHARE) sobre la calidad de vida y la salud general percibida de una muestra representativa de personas mayores españolas. Diseño Estudio descriptivo transversal. Emplazamiento España. Participantes La muestra estuvo compuesta por 4.498 personas mayores de 60 años que residían en la comunidad cuyos datos se obtuvieron de la sexta ola de la encuesta SHARE. Mediciones principales Se empleó un modelo de ecuaciones estructurales para definir el factor de fragilidad basado en los 5 indicadores físicos propuestos para SHARE (movilidad, apetito, fatiga, actividad y fuerza), y se puso a prueba su efecto sobre la calidad de vida y la salud percibida. Resultados Los resultados mostraron un excelente ajuste del modelo a los datos (p < 0,001, CFI = 0,977 y SRMR = 0,041). La capacidad predictiva de la fragilidad sobre la calidad de vida fue del 39,5% y sobre la salud percibida, del 61,6%. Conclusiones El factor latente de fragilidad presentado en este constructo ajusta y es sólido. Se pone de manifiesto el papel predictor de la fragilidad sobre la calidad de vida y la salud percibida en una muestra de población mayor española.
Collapse
|
16
|
Factors Associated with Health-Related Quality of Life in Community-Dwelling Older Adults: A Multinomial Logistic Analysis. J Clin Med 2019; 8:jcm8111810. [PMID: 31683766 PMCID: PMC6912260 DOI: 10.3390/jcm8111810] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 10/23/2019] [Accepted: 10/25/2019] [Indexed: 02/06/2023] Open
Abstract
The main aim of this study was to determine the association of various clinical, functional and pharmacological factors with the physical (PCS) and mental (MCS) summary components of the health-related quality of life (HRQoL) of community-dwelling older adults. Design: Cross-sectional study. Patients and setting: Sample of 573 persons aged over 65 years, recruited at 12 primary healthcare centres in Málaga, Spain. Sociodemographic, clinical, functional, and comprehensive drug therapy data were collected. The main outcome was HRQoL assessed on the basis of the SF-12 questionnaire. A multinomial logistic regression model was constructed to study the relationship between independent variables and the HRQoL variable, divided into intervals. The average self-perceived HRQoL score was 43.2 (± 11.02) for the PCS and 48.5 (± 11.04) for the MCS. The factors associated with a poorer PCS were dependence for the instrumental activities of daily living (IADL), higher body mass index (BMI), number of medications, and presence of osteoarticular pathology. Female gender and the presence of a psychopathological disorder were associated with worse scores for the MCS. The condition that was most strongly associated with a poorer HRQoL (in both components, PCS and MCS) was that of frailty (odds ratio (OR) = 37.42, 95% confidence interval (CI) = 8.96–156.22, and OR = 20.95, 95% CI = 7.55–58.17, respectively). It is important to identify the determinant factors of a diminished HRQoL, especially if they are preventable or modifiable.
Collapse
|
17
|
Godin J, Theou O, Black K, McNeil SA, Andrew MK. Long-Term Care Admissions Following Hospitalization: The Role of Social Vulnerability. Healthcare (Basel) 2019; 7:healthcare7030091. [PMID: 31311101 PMCID: PMC6787656 DOI: 10.3390/healthcare7030091] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 07/09/2019] [Accepted: 07/11/2019] [Indexed: 11/16/2022] Open
Abstract
We sought to understand the association between social vulnerability and the odds of long-term care (LTC) placement within 30 days of discharge following admission to an acute care facility and whether this association varied based on age, sex, or pre-admission frailty. Patients admitted to hospital with acute respiratory illness were enrolled in the Canadian Immunization Research Network's Serious Outcomes Surveillance Network during the 2011/2012 influenza season. Participants (N = 475) were 65 years or older (mean = 78.6, SD = 7.9) and over half were women (58.9%). Incident LTC placement was rare (N = 15); therefore, we used penalized likelihood logistic regression analysis. Social vulnerability and frailty indices were built using a deficit accumulation approach. Social vulnerability interacted with frailty and age, but not sex. At age 70, higher social vulnerability was associated with lower odds of LTC placement at high levels of frailty (frailty index (FI) = 0.35; odds ratio (OR) = 0.32, 95% confidence interval (CI) = 0.09-0.94), but not at lower levels of frailty. At age 90, higher social vulnerability was associated with greater odds of LTC placement at lower levels of frailty (FI = 0.05; OR = 14.64, 95%CI = 1.55, 127.21 and FI = 0.15; OR = 7.26, 95%CI = 1.06, 41.84), but not at higher levels of frailty. Various sensitivity analyses yielded similar results. Although younger, frailer participants may need LTC, they may not have anyone advocating for them. In older, healthier patients, social vulnerability was associated with increased odds of LTC placement, but there was no difference among those who were frailer, suggesting that at a certain age and frailty level, LTC placement is difficult to avoid even within supportive social situations.
Collapse
Affiliation(s)
- Judith Godin
- Division of Geriatric Medicine, Nova Scotia Health Authority, Dalhousie University, 5955 Veterans' Memorial Lane, Halifax, NS B3H 2E1, Canada
| | - Olga Theou
- Division of Geriatric Medicine, Nova Scotia Health Authority, Dalhousie University, 5955 Veterans' Memorial Lane, Halifax, NS B3H 2E1, Canada
| | - Karen Black
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Shelly A McNeil
- Division of Infectious Diseases, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Melissa K Andrew
- Division of Geriatric Medicine, Nova Scotia Health Authority, Dalhousie University, 5955 Veterans' Memorial Lane, Halifax, NS B3H 2E1, Canada.
| |
Collapse
|
18
|
Frailty and mental health: association with cognition, sleep, and well-being in older adults. Int Psychogeriatr 2019; 31:755-757. [PMID: 31292018 DOI: 10.1017/s1041610219000863] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
|